Wii-habilitation? The continuing evolution of video games and medicine

The popular Nintendo Wii console offers video games that venture into the world of exercise, but scientists now are taking it further, to help doctors heal the body.

The key behind the Wii is its motion-sensitive wireless controller, the Wii Remote, or the “Wiimote,” with which players control actions on screen. Players can swing the controller to simulate countless realistic motions, such as swatting a baseball for a home run. Such technology is becoming increasingly popular — at this year’s Electronic Entertainment Expo (E3), Sony and Microsoft both revealed motion-sensitive game controllers.

Playing with the Wii could help surgeons in training improve their fine motor skills and performance in a surgical simulator. Eight trainees were asked to play the Wii for an hour before performing virtual laparoscopic surgery with a tool that simulates a patient’s body and tracks the surgeon’s movements as he or she operates.

The Wii-playing residents scored 48 percent higher than others without the warm-up with the Wii, working faster and more accurately. Although the researchers first relied on off-the-shelf Wii games, they will soon release a complete surgical training system they designed for the Wii, where trainees can practice suturing and other procedures.

“There’s really no accurate way to train surgeons in the operating room, so it’s virtually all the on-the-job training, which is very time-inefficient,” explained researcher Mark Smith, an endoscopic surgeon at Banner Good Samaritan Medical Center in Arizona. “There are surgery simulators out there, but these are still very expensive. With the Wii, we have a very easy and inexpensive platform where surgery residents can learn and develop their skills.”

“You can even have the surgeons train at home,” added researcher Kanav Kahol, a biomedical informatician at Arizona State University. Although the Wii could help surgeons train in virtually any surgical specialty, the researchers are especially interested in using the console to teach robotic surgery, where surgeons can use robots for precise, minimally invasive procedures or to help patients at remote locations.

The Wii is also helping patients with Parkinson’s disease gain or maintain their independence with physical activities. Occupational therapists at Medical College of Georgia are using the console with patients to help them exercise.

“One of the therapists uses the Wii for timing and loosening up, and the other uses it for coordination and balance issues,” said researcher Ben Herz. “These therapists are thinking way out of the box. They’re doing activities that will make a difference in these participants’ lives based on what we know about Parkinson’s.”

Doctors at NewYork-Presbyterian Hospital/Weill Cornell Medical Center are using the Wii to help scan through an ever-increasing workload of patient X-ray and MRI images. Instead of spending hours at a time navigating through pictures using basic keyboard and mouse clicks, which can lead to repetitive motion injuries such as carpal tunnel syndrome, one cycles through scans with the Wii by just rotating the wrist.

“The remote is very intuitive,” explained George Shih, a radiologist at Weill Cornell Medical College, who with his colleagues helped develop the system that links the Wii remote to the diagnostic computer.

At Weill, “Wii-habilitation” therapists are using the console to help patients with burn injuries. For such patients, moving and stretching the skin is very painful, but crucial for a successful recovery.

“If a burn injury is near joints, the healing process makes the skin tight, so the natural tendency is not to move normally,” said Roger Yurt, chief of burn surgery at NewYork-Presbyterian Hospital/Weill Cornell Medical Center. “However, if the patients don’t, the joint itself starts to get stiff, so right from the beginning after a significant burn injury, patients have to start doing physical therapy.”

The researchers have found that Wii games not only help the burn patients exercise as they need to, but “get their mind off their disease, accomplish the objectives of the therapy without being routine and boring and monotonous,” said researcher and physical therapist Sam Yohannan at NewYork-Presbyterian Hospital/Weill Cornell Medical Center.

“If they’re in for multiple surgeries, for an extended period of time, it gives them a little bit of escape, doing some sort of sport with scenery that’s typically outdoors,” Yohannan added. “And it also improves socialization, and that’s a big part of burn rehabilitation and therapy, to get social support.”

Such research, or “Wii-search” as Yohannan said he sometimes calls it, “is very cutting edge, and there will be a lot more in the future, to see why and how games can better improve the health of patients. It’s a great and inexpensive technology.”